Abstract

Objective : This article reviews the role of energy and diet in the aetiology, treatment and prevention of athletic menstrual dysfunction.

Data sources and extraction : Research reviewed was derived from English language journals.
Data synthesis : Although a number of factors may contribute to the development of athletic menstrual dysfunction, negative energy balance while participating in strenuous physical activity, appears to be the primary factor. Numerous studies have compared the energy intakes of athletes with and without menstrual dysfunction, but only 4 studies have carefully measured energy balance using 7-day diet and activity records. In all 4 of these studies, a negative energy balance was reported in active women with menstrual dysfunction. Only 2 studies have attempted to reverse menstrual dysfunction by improving energy balance, but these studies were too short and had small sample sizes. Thus it is not known what level of negative energy balance triggers the development of this disorder. The primary nutrition related health consequences of athletic menstrual dysfunction are suppressed reproductive hormones, the potential for poor bone health, low nutrient intakes (protein, carbohydrate, essential fatty acids, calcium, B vitamins, iron and zinc), and the risk of developing disordered eating behaviours.
Conclusions : A growing body of research indicates that a negative energy balance is the primary factor contributing to athletic menstrual dysfunction. Treatment and prevention of this disorder need to focus on improving energy balance, while allowing for sport participation and the maintenance of a competitive body weight and composition (n=240).